Long-term follow-up after radiofrequency catheter ablation for atrial fibrillation

Aims: Data on long-term follow-up of patients who have undergone catheterablation for atrial fibrillation (AF) are very limited. Thisreport aimed at presenting clinical outcome and AF-free survivalafter pulmonary vein (PV) isolation over an extended (>3years) follow-up period. Methods and results: Thirty-nine patients subjected to PV isolation for paroxysmalAF were followed-up for at least 3 years according to a strictprotocol. Fourteen patients (35.8%) had one, 19 patients (50%)had two, and 6 patients (15.4%) had three ablation procedures.At end of follow-up (42.2 ± 6.0 months), 17 patients(43.5%) were completely free of AF or other atrial arrhythmia,and 26 patients (66.6%) had symptomatic improvement. The long-termsuccess rate was 21.4% for patients subjected to a single ablationprocedure, 52.6% for patients subjected to two catheter ablationprocedures, and 66.7% for patients who underwent three ablationprocedures (P = 0.094). There was also a trend for patientswho underwent a combination of different ablation procedures(ostial, antral, and/or circumferential) to have a higher AF-freesurvival when compared with patients subjected to the same procedure(P-value for log-rank test = 0.036). Conclusion: Catheter ablation does not eliminate paroxysmal AF in up to56% of patients in the long term, despite the use of two orthree ablation procedures in two-thirds of them. However, itconfers symptomatic improvement in 67% of treated patients.